IVF Miscarriage & PCOS Questions Explained by Dr. Zhang

We've been interviewed many fertility specialists and book authors to talk about alternative infertility treatments. Dr. Zhang from New Hope Fertility Center is the first person here to share fertility knowledge from a doctor's point of view with us. He is the leading expert in the industry. He and his team have helped hundreds of couples successfully welcome their new babies. In the interview, Dr. Zhang will answer the questions about miscarriage and the symptoms of PCOS, as well as introduce different kinds of IVF treatments. Take a look at this interview to learn the correct fertility information from the authority.

Hello Dr. Zhang. Can you tell us your background, expertise and a little bit about NHFC?

My Background originates with OBGYN. I received my medical Degree in China and Zhejiang University School of Medicine and then pursued a Masters in the UK at Birmingham. It was there that I honed my talent, met with the queen, and realized my dream of helping people have families when they thought all hope had run out. It was with this in mind that I opened my clinic, New Hope Fertility Center. With a strong focus on developing new techniques and technology, we strive to make family a reality for everyone and anyone. We operate under a “one good egg policy,” which means that all it takes is one good egg to start a family. We cater to low drug and natural protocols, which are perfectly suited for anyone who wants to avoid heavy drugs, have delicate systems that may react badly to hormone therapy, or difficult medical conditions.

We know many couples have experienced difficulties when trying to conceive. How long do you think a couple should try before they go see a doctor?

By definition, infertility can be diagnosed after 6 months of trying for over 35 years old (typically easier to conceive) and 1 year for under 35 (keep trying). But infertility is only one reason you might come to see a specialist. Fear of sex or complicated situations may bring you in. STI’s and other diseases that you don’t want to pass on to your children may bring you in for assistance. Same sex couples come in regularly, and physically there is nothing wrong with them. But if you are two women or two men, conceiving on your own will be a challenge. We help because everyone deserves to have a chance at raising a family. So I cannot say exactly, try for a time and then come in. Too many special cases. But most people know when they are trying that maybe they need help. It should not be embarrassing. There is nothing wrong with assisted reproduction.

What is the definition of miscarriage? What are the common reasons of miscarriages? Does a woman's fertility get affected after miscarriages? If so, how?

Miscarriage is defined as the loss of an embryo or fetus before the 20th week of pregnancy. Most miscarriages occur during the first 14 weeks of pregnancy. The medical term for miscarriage is spontaneous abortion or SAB. Miscarriages happen for a number of reasons, and sometimes we can’t identify why. However, usually this doesn't impact a woman’s fertility and we always like to encourage women to try again. There is a huge emotional impact though, and we always suggest dealing with the loss seriously before moving forward to a second attempt. Also, if you are conceiving naturally, but having repeated miscarriages, definitely seek a specialist opinion.

We've featured a few fertility bloggers who have infertility issue due to PCOS, and many of them don't even realize they have this health issue until they are trying to get pregnant. Can you tell us the symptoms of this disease? How to cure it? Does it affect fertility permanently?

PCOS symptoms include weight gain, hair loss, heavy periods, irregular menstrual bleeding, acne, oily skin, fertility problems. PCOS has no cure, but the symptoms can be managed by medications. These medications include metformin, clomid, etc. to improve fertility outcomes. One of the more important considerations is for women who have OHSS or are at risk of hyper stimulating. This makes it complicated to be given drugs that stimulate the ovaries since overstimulation is very dangerous to the patient.

We hear about many infertility treatments, including IVF of course. But it's the first time we see mini-IVF. Can you explain what that is and how it's different from traditional IVF.

In traditional IVF a woman’s ovaries are stimulated to produce eggs on command, and large quantities. This is done through a regiment of injected hormone therapy and fertility drugs that trick the body into thinking it is time to mature and release an egg. For many women, this is uncomfortable, expensive, and time consuming. After “triggering” the follicles to produce mature eggs, we then inseminate them through one of several different ways. But ‘in vitro’ refers to happening in a test tube or a petri dish.

In mini-ivf, we don’t stimulate the follicles to the same extent using injectable. We run a course of carefully monitored oral medication which tends to be easier on the body and allows us to customize the dose more effectively. There may still be injections, but significantly less.

Because of the lower drug course and the time it all takes, this will also be more cost effective than conventional.

We also developed ULTRA MINI IVF which is a step further and contains absolutely no injectables. Finally, we offer Natural IVF which uses no drugs until you are ready for your egg retrieval. In this case, we retrieve only one egg, at the time that your body has indicated it is most ready to release it. This is all about the timing and you only get one egg at a time, so depending on your medical history and age, this is effective for a select group of people.

Your doctor can help you decide which is the best course for you, and if they are like us, we offer skype consultations around the world and can work with your doctor on treatment that fits into your life.

Anything else you'd like to share with us?

New technology is always coming out. We are doing genetic selection allowing patients to choose the gender of their baby. We can do screening allowing us to virtually eliminate the risk of many diseases and disorders like Trisomy 21 (downs syndrome). It’s not genetic testing, but by selecting the best egg and the best sperm, we can ensure a higher chance of success, allowing us to reduce the expense you will incur as a patient.

We are doing lots of research into egg freezing and allowing older women to have children later in life. I can’t talk too much about this, but we can actually now take the DNA of an older woman and replace the DNA in a donor egg-we call this egg rejuvenation.

There is so much out there going on that we are constantly learning. I am helping to save the North African White Rhino’s using IVF. Stem cell research is getting very popular too. And Egg Freezing with Vitrification, something I helped pioneer in the USA, is now mainstream allowing women to preserve their fertility indefinitely with high success! We can do complete or partial ovarian transplants and we can help you preserve your fertility in the case of cancer treatments or anything else that may interfere with your dreams of family in the future.

About John Zhang, MD, MsC, PhD

Board Certified in Obstetrics and Gynecology from The American Board of Obstetrics and Gynecology A true pioneer in the area of minimally invasive (Natural Cycle and Mini-IVF™) fertility care, Dr. John Zhang founded New Hope Fertility Center in 2004, and has since opened locations in China, Russia, and Mexico.

Since opening, Dr. Zhang has been behind several notable achievements in the area of assisted reproductive technology (ART), including the birth of a child by a 49 year-old using her own eggs, helping to restore a young woman’s fertility through a recent ovarian tissue transplant surgery in February of 2012, and being named one of New York’s Top Doctors in 2011.

Dr. Zhang completed his medical degree in at the Zhejiang University School of Medicine, and subsequently received his Master’s Degree at Birmingham University in the UK. In 1991, Dr. Zhang earned his Ph.D. in In-Vitro Fertilization (IVF), and, after studying and researching the biology of Mammalian Reproduction and Human Embryology for nearly ten years, became the first Fellow in the Division of Reproductive Endocrinology and Infertility of New York University’s School of Medicine in 2001.

Keep up with the latest from Dr. Zhang on his blog where he talks about trending topics in the field of Assisted Reproductive Technology.

Message from Dr. John Zhang

“The first thing that we do is talk to our patients to understand their unique needs. Then we create a customized fertility care plan. This system has allowed New Hope to have many successes, including breaking the age barrier for women who previously had trouble conceiving.”